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The Intrapartum and Postpartum Care of Women Following Assisted Reproduction Techniques (ART)

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Clinical Management of Pregnancies following ART

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Abstract

Pregnancies conceived through ART are significantly more complex than those resulting from spontaneous conception. They should be considered at a higher risk of complications in the intrapartum and postnatal period. The multifactorial nature of infertility both voluntary and involuntary has led to women being older at the outset of their first pregnancy, with a higher incidence of comorbidities including obesity, hypertension and diabetes. This has further implications for labour and the puerperium. From a healthcare perspective, there is an emerging trend of both obstetricians and midwives viewing patients who conceive through ART as carrying “precious” pregnancies. This protective attitude is especially evident in older women who may have had multiple attempts to conceive and achieving another pregnancy may prove challenging. The concern about minimising adverse fetal outcomes and fear of litigation leads to medical staff having a lower threshold for intervening earlier and offering induction of labour/operative delivery. The mental well-being and psychological coping strategies of women who conceive with ART are also different from spontaneously conceived pregnancies. The emotionally demanding aspects of fertility treatment positively prepare some women to deal with the unexpected complications of childbirth whereas for others these same factors can lead to anxiety about delivery. Fertility specialists must ensure that that they maximise maternal health before offering In vitro fertilisation (IVF) treatment and continue to reduce the multiple pregnancy rate. Robust referral pathways and timely communication between IVF units and antenatal services is pivotal to highlighting and triaging the obstetric needs of these patients. Seamless multidisciplinary involvement with maternal medicine physicians and mental health services where appropriate will further empower patients to lead a smoother course in their pregnancies.

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Author information

Authors and Affiliations

  1. Division of Obstetrics, Gynaecology, and Child Health, Queens Medical Centre, Nottingham, UK

    Sonia Asif MBChB, MRCOG

  2. Department of Obstetrics and Gynaecology, Sherwood Forest Hospitals NHS Foundation Trust, Sutton-In-Ashfield, UK

    Srini Vindla MB, BS, BSc, FRCOG, DM

Authors
  1. Sonia Asif MBChB, MRCOG
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  2. Srini Vindla MB, BS, BSc, FRCOG, DM
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Corresponding author

Correspondence to Sonia Asif MBChB, MRCOG .

Editor information

Editors and Affiliations

  1. Department of Maternity and Gynaecology, Royal Derby Hospital, University of Nottingham, Derby, United Kingdom

    Kanna Jayaprakasan

  2. Department of Obstetrics, Nottingham University Hospitals, Nottingham, United Kingdom

    Lucy Kean

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Asif, S., Vindla, S. (2017). The Intrapartum and Postpartum Care of Women Following Assisted Reproduction Techniques (ART). In: Jayaprakasan, K., Kean, L. (eds) Clinical Management of Pregnancies following ART. Springer, Cham. https://doi.org/10.1007/978-3-319-42858-1_11

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  • DOI: https://doi.org/10.1007/978-3-319-42858-1_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-42856-7

  • Online ISBN: 978-3-319-42858-1

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